Affidavit Of State Official Establishing Facsimile Signature
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Affidavit Of State Official Establishing Facsimile Signature Form. This is a West Virginia form and can be use in For Government Secretary Of State.
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AFFIDA
STA
AFFIDAVIT OF STATE OFFICIAL
ESTABLISHING FA
SIGNA
ESTABLISHING FACSIMILE SIGNATURE
STATE OF WEST VIRGINIA
, after being first duly sworn by the
undersigned Secretary of State, on oath, deposes, says and certifies:
1.
That he or she is
(Title)
of
.
2.
That in order to establish a facsimile signature to be used in lieu of his or her manual
signature, as authorized by Chapter 6, Article 14, of the Code of West Virginia of 1931, as amended, he
or she hereunto affixes his or her manual signature to this affidavit form and authorizes the same to
be certified to and filed with the Secretary of State of West Virginia.
3.
That his or her term of office ends as of
.
Signature
I,
Secretary of State of the State of West Virginia, do
hereby certify that the above named
who is well known to me,
personally appeared before me this day and made oath as noted above, and affixed his or her manual
signature to the above affidavit; that he or she is the duly qualified and acting
of
.
Accordingly, said affidavit is this day admitted to record in my office at the State Capitol, and I
hereby certify that the manual signature of the affiant may be reproduced as the facsimile signature of
an authorized officer by engraving, imprinting, stamping or by other means, as authorized by Chapter
6, Article 14, of the Code of West Virginia of 1931, as amended, during the term of his or her office as
aforesaid.
In Witness whereof, I have subscribed my signature,
and caused the Great Seal of the State to be affixed
hereto this
day of
,
.
(SEAL)
Secretary of State
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